HomeMy WebLinkAbout107125 BIVENS TRUCKING & EXCAVATING INC - INSURANCE CERTIFICATE (12)Date: 9/26/03 Time: 12:14 PM To: ® 91970-221-6707
Pinnacol Assurance Page: 002.003
PRODUCER
Pinnacol Assurance
7501 E Lowry Blvd
DENVER CO 80230-7006
INSURED
BIVENS TRUCKING & EXCAVATING INC
3900 IDEAL DRIVE
FORT COLLINS CO 80524
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,
NOTWITHSTANDING ANY REQUIREMENT, TERM AND CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE
ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS
OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
W TYPE OP INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIPATION LIMITS
LTR D,AT miry MT a
GPITPRAI. LIABILITY OENERALAOOREGATE
COMMERCIAL OEWb LIABILITY PRODUCTS - COMP OP AGO
4_AIMS MADE OCCUR PERSONA Aft IWLRLY
OWNER'S 2 CANTRACTOR'S PROT EACH OCCURRENCE
FIRE DAMAOE om Ills
ANYAUTO
ALLOWNEDAUTOS
BODILY INNRY
SCHEDULED AUTOS
BODILY INNRY
HIRERAMOS
NON OWNED AUTOS
'eccihN
.RACE LIABILITY
ANY AUTO
PXCRSS LIABILITY
UMBRELLATOPM
O[HFR THAN UMBRELLA FORM
eA�+l luurtrtervi.e
AGOREOATE
A
WORXERSCCMPENSATIONAND
EMPLOYERS' LIABII ITY
THEPROPRIEIOWPAPTNER INCL
EXECUTIVE OPPICERS ARE: EXCL
3241983
08/01/2003
08/01/2004
Xi WCSTATU- OTHER
TORY LIMITS
...........................
..........................
..:........................
ELEAa ACCIDEN
$1,000,000
EL DISEASE - POLICY LIMB
1000000
EL DISEASE - EA EMPLOYEE
$1,000,000
OTHER
DPB IPTLONOFOMMTIONS/LACATIONS/VEIBCLES/SPMIALITBMS
SEE BACK OF CERTIFICATE FOR CLASS COVERAGE AND OWNERSHIP COVERAGE DETAIL
719307
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF FT COLLINS
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
ATTN: PURCHASING DIVISION
_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
215 N MASON ST 2ND FLOOR
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
FORT COLLINS CO 80524
LIABILITY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Charles Doggett
APOUMD CSR Supµ+el 09/2W3 U:16:013U15 UpdaW 12/15AM 12:W0 MBS